1983, 03-15 Permit: 83A-1872 PatioPLAN NUMBER
0)
APPLICA T-ION�ERMIT
SPOKANE COUNTY — DEPART F BUILDING & SAFETY
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
1.
2.
STREET ADDRESS
118p
LOT
BLOCK
PARCEL NO.
E lc rv.t,
2754-'2-/3(.. (
SUBDIVISION
0-9?e(2--CtA.A., TC0E 47-4A
3.
4.
5.
OWNER
MAILING ADDRESS
CONTRACTOR
SochYvt E
ADDRESS
s:r Not -6
DESIGNER
PHONE
Akrr�tor��/
PHONE
LEGAL DESCRIPTION:
ZIP
rtnR c.>
Actual Set Backs in Feet to:
North 'South East
West
LICENSE EXPIRES
PHONE
Size of Parcel Zone ^Classification
K
Residential Car.
Commercial ❑
ZIP
Type Const.
Occupancy
12-3
Sprinklered
❑Yes ❑No Req 'd.
PHONE
N Const. Valuation
6.cav
Remode ed Valuation
bon.1
Total Bldg. Floor Area
ADDRESS
ZIP
Main Floor
Upper Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
6.
TO
Cover Deck
Uncv. Deck
Fin. Eaggatzt
Unf in. Basement
TYPE ❑ NEW /ALT. ❑ AD' N. ❑ RPL. ❑ MVE.
7. OF
WORK I'BLD. ❑ PLMB. ElMECH. ❑ M.H. ❑ POOL
❑ OTHER
No. Baths
No. Floors
No. Fin. Rooms
No. Dwellings
Certif1. of Exempt.
or Variance
Required
Received
Yes❑ No
Yes❑ No
Number
DESCRIBE WORK
8' e.NC..44,5 v
ex,c 5-c c u h '2(2;c,c- ' C I )
Shorelines/Flood Hazard
Yes❑ Not Applic. ❑
Plans Required �
Received ❑
4ALUATI ON
9. CpC2
SOURCE
F
UTILITIES
GAS
ELECTRIC
WATER
PUBLIC ❑
PRIVATE 0
SEWAGE
SEPTIC cess
SEWER 0
Ownership
Public 0 Private
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included on
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVESE SIDE FOR REQUIRE 94 ISPECTIONS
SIGNATURE OF
OWNER OR AGENqk
YbL:P/.t
APPLICAT 9N — /
DATE X
SPECIAL APPROV S SPECIAL CONDITIONS: (S /(REVERSE SIDE FOR NOTICE)
PRELIM. FI DATE
Env. Health
Planning
Fire
Prevent.
Engineer
Utilities
SEPA
Plans
Exam.
Building
Tech.
PERMIT IS NONTRANSFERABLE
PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
IN 180 DAYS
FEES COLLECTED
Building '2o -4>c
Plumbing
Mech.
Plan Check
SEPA
Modular/
MFG. Home
Other (Specify)
TOTAL $ .9_.cr)
PERMIT NUMBER
SaA-1812
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
DATEQS81JEb1 5 - 8 3
PERMIT]N . 7. 2
*20,004AL